Healthcare Provider Details

I. General information

NPI: 1184421158
Provider Name (Legal Business Name): FENIX WELLNESS ADULT DAYCARE, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9855 E FERN ST
PALMETTO BAY FL
33157-5413
US

IV. Provider business mailing address

9855 E FERN ST
PALMETTO BAY FL
33157-5413
US

V. Phone/Fax

Practice location:
  • Phone: 786-404-1008
  • Fax:
Mailing address:
  • Phone: 786-404-1008
  • Fax: 786-600-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADANYS ALONSO-ALFONSO
Title or Position: CEO
Credential:
Phone: 305-998-7885